Q--I started to gain weight when my doctor prescribed medicine for depression. Why?
A--There are some helpful medical treatments for depression, but like all drugs, they have some side effects. The unwanted side effects may cause patients to stop taking the medicine or take less than prescribed. Sometimes it is helpful to understand the side effects so they can be managed and the drug continued.
Increased appetite is one side effect commonly reported by people taking antidepressants. These people say they crave sweets and end up gaining weight. Those most likely to gain weight are people who were overweight before taking the medications.
Once it was believed that the increased appetite was the result of the feeling of calm and well-being that the drug promoted. This is not the case. The explanation is more complex, involving chemicals in the brain that affect appetite. Each drug is different; some have less effect on appetite than others.
Do not adjust your medicine or quit taking it. Talk with your physician if you are gaining weight. He may be able to change your treatment so you get the benefits of antidepressive drug therapy but fewer side effects.
Q--My husband suffers from chronic migraine headaches. Now the school nurse tells me that our young daughter complains of terrible headaches. Is it possible for a child to have migraines and to inherit them from a parent?
A--Children can and do get migraine headaches, particularly if migraines run in the family. Attacks in children are similar to adult-sized migraines but of shorter duration, and may be accompanied by nausea, vomiting and sensitivity to light.
Evidence is growing that genetics plays a key role in childhood migraines, and so it is possible that your daughter inherited your husband`s predisposition toward these painful episodes. You may want to have her see your family doctor for a complete physical and blood-screening test and follow the course of diagnostic tests that may be necessary to determine the true nature of your daughter`s problem.
It also is important to make sure that her headaches are not triggered or magnified by emotional stresses in the household, particularly in reaction to the pain itself. Your daughter needs all the love and support you can give her to help her through this difficult period. If the diagnosis of migraine is confirmed, the chances are only 1 in 3 that her headaches will disappear as she approaches late adolescence.
Dear Readers: I receive many questions about Alzheimer`s disease and new means of diagnosis, treatment and research. A great deal of important material is available from the Alzheimer`s Disease and Related Disorders Association, Department F, 70 E. Lake St., Chicago, Ill. 60601. Please include a stamped, addressed, business-size envelope for general information, lists of local chapters and resources. You also may telephone (800) 621-0379, or (800)
572-6037 in Illinois, for a more rapid response to a specific question or need.
Q--Can you tell me what ``supermarket elbow`` is?
A--``Supermarket elbow`` is one name for an injury to the soft tissue of the elbow. It often occurs in children ages 2 to 5, and it`s also called
``pulled elbow`` or ``nursemaid`s elbow.`` The elbow is actually
``dislocated`` and requires treatment by a physician. The child cries from pain and protects the elbow from use.
How does it happen? Picture yourself and your little one in the supermarket. She insists on candy, and you find yourself firmly escorting her away. Chances are, you pull on her forearm, and she resists your efforts. A familiar scene? The movement is not particularly harsh, but it is enough to strain the soft tissue around a young child`s elbow. Playfully swinging a young child by his arms can also cause the elbow injury, as can ``helping`` a young toddler to walk by holding them up by both hands.
When you must quickly restrain a child, hold his arm above the elbow. Never grab the forearm or hand. And when playing with a young child, be aware of the delicate soft tissues of his elbow, and place no strain on them.
Q--A friend is quite ill. He has to have fluid taken out of his belly every few weeks. What causes this it?
A--The condition your friend suffers from is known as ``ascites`` (from a Latin word meaning ``a bag``). Liquid forms in the abdominal cavity and, because it has no way of getting out, must be removed. Usually this condition occurs when there is a serious, chronic liver condition. The most common cause is cirrhosis which, as you may know, can result from severe alcoholism. There are other possible causes, including heart failure, kidney disease and some forms of cancer. The manner in which the liquid is formed is pretty complex and still not completely understood by scientists.
Dr. Bruckheim welcomes questions from readers. He cannot respond individually, but he will answer those of general interest in his column. You may write to Dr. Bruckheim in care of The Chicago Tribune, P.O. Box 119, Orlando, Fla. 32802-0119.